Healthcare Provider Details
I. General information
NPI: 1275922346
Provider Name (Legal Business Name): ALASKA CENTER FOR PAIN RELIEF INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/13/2015
Last Update Date: 07/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3851 PIPER ST STE U464
ANCHORAGE AK
99508
US
IV. Provider business mailing address
3851 PIPER ST STE U464
ANCHORAGE AK
99508-6905
US
V. Phone/Fax
- Phone: 907-339-4800
- Fax: 907-339-4801
- Phone: 907-339-4800
- Fax: 907-339-4801
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRISTOPHER
GAY
Title or Position: PRESIDENT
Credential: MD
Phone: 907-339-4800